Skip to main content
SafeMama

Disclaimer: This guide is for education only and is not a substitute for professional medical advice. Always confirm medicine, supplement and product decisions with your obstetrician, midwife, pharmacist or healthcare provider.

Medication

Is Methotrexate Safe During Pregnancy?

Published 2026-08-01 | By SafeMama Editorial Team | Editorial policy

Is Methotrexate Safe During Pregnancy? pregnancy safety guide image

Short answer

Methotrexate is generally not compatible with an ongoing pregnancy except when a clinician intentionally uses it to treat selected ectopic pregnancies. Contact your specialist urgently if pregnancy is possible or confirmed while taking it.

Urgent specialist review

What is the safest way to think about this?

MotherToBaby covers methotrexate as a pregnancy exposure that needs medical review, and NHS guidance says methotrexate is not recommended in pregnancy and that people planning pregnancy need advice before stopping or trying. Ectopic pregnancy treatment is a separate clinician-managed situation.

What is generally okay?

  • Call the prescribing specialist promptly if you are pregnant, trying to conceive or had an exposure around conception.
  • Ask when it is safe to try for pregnancy after stopping methotrexate for your dose and indication.
  • Keep dose, schedule, last dose date, folic acid plan and reason for treatment ready for review.

What should you avoid or double-check?

  • Avoid taking methotrexate during a known or possible ongoing pregnancy unless it is being used intentionally for ectopic pregnancy treatment under medical care.
  • Avoid stopping an immune, cancer or ectopic-pregnancy plan without specialist direction.
  • Avoid taking extra folate or rescue medicines unless your clinician tells you exactly what to do.

How SafeMama helps

SafeMama can flag methotrexate, Trexall, Otrexup, rheumatoid arthritis, psoriasis, ectopic pregnancy treatment, folic acid and chemotherapy labels for urgent clinician review.

Open the SafeMama app, scan the barcode or search the ingredient, then use the result as a starting point for a conversation with your healthcare provider.

Sources

Frequently asked questions

Is methotrexate ever used in pregnancy care?

Yes, clinicians can use methotrexate to treat selected ectopic pregnancies. That is not the same as continuing routine methotrexate for another condition during an ongoing pregnancy.

What if I took my weekly methotrexate before a positive test?

Call the prescribing specialist or pregnancy clinician urgently with the dose and date. Do not try to solve it from online advice.

Can I breastfeed while taking methotrexate?

Guidance depends on dose and timing. NHS says low weekly doses may sometimes be compatible with a 24-hour pause, while higher doses need individualized advice.

Check products faster with SafeMama

SafeMama scans food, skincare, medicine and supplement labels and explains pregnancy-safety flags using published guidance from authorities like ACOG, NHS, FDA, CDC and WHO.

Download SafeMama